Provider Demographics
NPI:1295495109
Name:MARCIE COURTER PSYD, LLC
Entity type:Organization
Organization Name:MARCIE COURTER PSYD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:COURTER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:808-866-4245
Mailing Address - Street 1:1325 S KIHEI RD STE 226A
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-8180
Mailing Address - Country:US
Mailing Address - Phone:808-866-4245
Mailing Address - Fax:808-573-0252
Practice Address - Street 1:1325 S KIHEI RD STE 226A
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-8180
Practice Address - Country:US
Practice Address - Phone:808-866-4245
Practice Address - Fax:808-573-0252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-20
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health